Cushing's syndrome (CS) is a severe condition that results from chronic exposure to elevated circulating cortisol levels; it is a rare but potentially life-threating condition, especially when not timely diagnosed and treated. Even though the diagnosis can be straightforward in florid cases due to their typical phenotype, milder forms can be missed. Despite the availability of different screening tests, the diagnosis remains challenging as none of the available tools proved to be fully accurate. Due to the ubiquitous effect of cortisol, it is easy understandable that its excess leads to a variety of systemic complications including hypertension, metabolic syndrome, bone damages and neurocognitive impairment. This article discusses clinical presentation of CS with an eye on the most frequent cortisol-related comorbidities and discuss the main pitfalls of first- and second-line tests in endogenous hypercortisolism diagnostic workup.

库欣综合症（CS）是一种由于长期暴露于升高的循环皮质醇水平而导致的严重疾病。这是一种罕见但可能危及生命的疾病，尤其是在未及时诊断和治疗的情况下。尽管由于其典型的表型在小花病例中诊断很简单，但较轻的形式可能会漏诊。尽管可以使用不同的筛查测试，但是诊断仍然具有挑战性，因为没有可用的工具被证明是完全准确的。由于皮质醇的普遍作用，容易理解的是，皮质醇的过量会导致多种全身并发症，包括高血压，代谢综合征，骨骼损伤和神经认知障碍。